ArticleJournal of orthopaedic surgery and research2023
Do polyethylene wear particles affect the development of pseudotumor in total hip arthroplasty? A minimum 15-year follow-up.
Article in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 7 citations in OpenAlex.
- Inflammatory Pseudotumor After Total Hip Arthroplasty-An Increasingly Recognized Complication.Orthopaedic surgery · 2026Review
- Progressive wear divergence beyond 10 years in ceramic- vs. metal-on-polyethylene bearings: the 25-year impact of zirconia degradation in total hip arthroplasty.Journal of orthopaedic surgery and research · 2026Article
- Selenium nanoparticles alleviate cobalt toxicity in artificial joint metal prostheses by inhibiting ferroptosis through activation of the PRDX6/GPX4 pathway.Materials today. Bio · 2025Article
- Unexplained Pseudotumor Formation in Ceramic-on-ceramic Hip Bearings: A Case Report.Journal of orthopaedic case reports · 2025Article
- Pseudotumor following total hip arthroplasty: experience of a tertiary referral center and proposal of the new "PCS" classification system.Archives of orthopaedic and trauma surgery · 2025Article
- Head, acetabular liner composition, and rate of revision and wear in total hip arthroplasty: a Bayesian network meta-analysis.Scientific reports · 2023Article
- The effect and mechanism of iodophors on the adhesion and virulence of Staphylococcus aureus biofilms attached to artificial joint materials.Journal of orthopaedic surgery and research · 2023Article
- Review
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdverse local tissue reactions have been problematic as an implant-related complication in total hip arthroplasty (THA). Despite the absence of significant metal wear and corrosion, granulomatous pseudotumor has been reported to be caused by polyethylene wear. We performed a long-term follow-up study investigating the relationship between polyethylene wear and pseudotumor formation in THA.
methodsThis study included 57 patients (64 hips) that underwent primary THA with metal-on-polyethylene or ceramic-on-polyethylene bearing over a minimum follow-up of 15 years. They were stratified into pseudotumor and non-pseudotumor groups and their linear wear rates of polyethylene liner and serum cobalt (Co) and chromium (Cr) ion levels were compared. Pseudotumor was diagnosed on metal artifact reduction sequence-MRI according to its composition and wall thickness using the Hauptfleisch classification.
resultsThe incidence of pseudotumor was 34% (22/64 hips) at the mean follow-up of 16.9 years. Metal ion levels did not differ between the pseudotumor and non-pseudotumor groups, and none of the patients exceeded the Co/Cr ratio of 2.0 μg/L. Moreover, the wear rate in the pseudotumor group was 1.8 times greater than in the non-pseudotumor group (0.14 vs. 0.08 mm/year, P < 0.001). According to an analysis of the receiver operating characteristic curves, the cutoff level of the wear rate to discriminate between pseudotumor and non-pseudotumor patients at 15 years was 0.11 mm/year (area under the curve = 91%; sensitivity = 95%; specificity = 78%; accuracy = 87%).
conclusionsOur results might provide new insights into excessive polyethylene wear potentially leading to the future development of both pseudotumor and osteolysis. Further studies are needed to clarify the direct relationship between polyethylene wear and pseudotumor and the mutual effects of osteolysis and pseudotumor in particle reactions.
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